CN104010598A - Gastric,cutaneous or peritoneal delivery of frozen mist to induct therapeutic hyperthermia - Google Patents
Gastric,cutaneous or peritoneal delivery of frozen mist to induct therapeutic hyperthermia Download PDFInfo
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- CN104010598A CN104010598A CN201280053751.9A CN201280053751A CN104010598A CN 104010598 A CN104010598 A CN 104010598A CN 201280053751 A CN201280053751 A CN 201280053751A CN 104010598 A CN104010598 A CN 104010598A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/12—Devices for heating or cooling internal body cavities
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/0085—Devices for generating hot or cold treatment fluids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/02—Compresses or poultices for effecting heating or cooling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F2007/0059—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit
- A61F2007/0063—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit for cooling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F2007/0059—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit
- A61F2007/0069—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit with return means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F2007/0095—Heating or cooling appliances for medical or therapeutic treatment of the human body with a temperature indicator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/02—Compresses or poultices for effecting heating or cooling
- A61F2007/0225—Compresses or poultices for effecting heating or cooling connected to the body or a part thereof
- A61F2007/0233—Compresses or poultices for effecting heating or cooling connected to the body or a part thereof connected to or incorporated in clothing or garments
- A61F2007/0234—Compresses or poultices for effecting heating or cooling connected to the body or a part thereof connected to or incorporated in clothing or garments for the upper part of the trunk, e.g. bodice
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/12—Devices for heating or cooling internal body cavities
- A61F2007/126—Devices for heating or cooling internal body cavities for invasive application, e.g. for introducing into blood vessels
Abstract
Peritoneal heat exchange provides the benefit of extremely rapid cooling of the patient's target organs such as the heart and brain as well as facilitating global patient body temperature reduction to therapeutically effective temperatures. The heat exchange medium of the present invention is a chilled gaseous fluid suspension of frozen ice particles.
Description
cross reference
The application requires to be filed in JIUYUE, the 2011 U.S. Provisional Application No.61/531 of 5 days, and 052 rights and interests are incorporated to this application entirety herein by reference.
background of invention
invention field:present invention relates in general to the apparatus and method for optionally changing and control patient temperature.More specifically, it relates to by the endoperitoneal heat exchange of patient and reduces the relative Noninvasive of patient temperature and system and method that can execute-in-place.Peritoneum heat exchange provide cooling patient extremely fast such as the target organ such as heart and brain and promote overall patient temperature to be reduced to the benefit for the treatment of effective temperature.Heat exchange medium of the present invention is that the freezing gaseous fluid that freezes ice pellets is suspended thing.
background of invention:the mankind are considered to a kind of tropical animal.Human animal's normal function needs the body temperature of about 37 degrees Celsius (98.6 degrees Fahrenheits).Health can carry out a small amount of rising of self-compensation temperature or decline to change by the activation of the intrinsic thermoregulation system of the temperature receptor control by skin.The reaction that body temperature rise is changed is to cause perspire, like this moisture is moved to body surface from bodily tissue.In the time that moisture arrives body surface, evaporate, carry a certain amount of heat with it.That the fluid losing because of perspire must be supplemented for people being exposed to the explanation that hot environment a period of time can become thirsty.The reaction that temperature decline is changed is to tremble, and this is that health is attempting to produce heat.Trembling is extensive unconscious contraction and the expansion occurring of muscular tissue.This muscle movement is by friction generates heat.
Hypothermia is defined as core temperature lower than 35 degrees Celsius.Hypothermia is also considered to the clinical state of the subnormal temperature in the time that health cannot generate enough heats and effectively maintains function.Many variablees are facilitated hypothermic development.Age, health status, nutrition, body size, be completely exhausted, expose, expose persistent period, wind, temperature, humidity, medicine and narcotic and can reduce heat generation, increase thermal loss or disturb heat stability.Healthy individuals by conduction, convection current, radiation, evaporation and breathing to the compensatory response of thermal loss may be exposed overwhelm.Medicine can disturb thermoregulation.Acute or chronic central nervous system's process can reduce thermotaxic effectiveness.
Mild hypothermia is in the time that core temperature is 34-35 degree Celsius.Patient still vigilance and can oneself help, and start acutely tremble.But patient's motion becomes more inharmonious and cold some pain of generation and discomfort.
Moderate hypothermia is in the time that patient's core temperature is 31-33 degree Celsius.Tremble and slow down or stop, muscle starts to become stiff and occurs confusion and apathy.Speech becomes slow, fuzzy and ambiguous, breathes and becomes slow and shallow, and may occur sleepy and strange behavior.
Severe hypothermia is in the time that core temperature is brought down below 31 degrees Celsius.Skin cold, color may be pewter, eyes may be opened wide.Patient is very weak, shows obvious shortage coordination, inarticulateness, seems and is completely exhausted, and may be drunk shape, denies existing problems and may refuse one's help.Consciousness is lost gradually.Possible shallow breathing or without obviously breathing, patient may be very stiff, lose consciousness, and may seem dead.
Treat hypothermic straightforward procedure known very early.These class methods comprise patient are rolled in blanket, oral administration warmed fluid and patient is immersed in tepidarium.If hypothermia is not too serious, even if these straightforward procedures all can be proved effective.But the effectiveness of these straightforward procedures is limited.Patient is rolled in and in blanket, finally depends on patient self and produce heat and make its health rewarming.Even in the hypothermic situation of moderate, or the in the situation that of ill or wounded patient, patient is may be tangible too weak or be completely exhausted and can not produce enough heats.Orally administered warmed fluid needs patient's Consciousness and can swallow fluid.Because loss of consciousness occurs in hypothermic in early days, therefore the method is also limited to moderate case.It is usually at all unpractical that patient is immersed in tepidarium.For example, it is obviously less desirable soaking the patient who is undergoing surgery.In addition, immersion technology is consuming time and possibility is invalid, and this is because it need to be delivered to the warm skin surface from patient among body core, then could realize warm benefit.Other devices allow directly to warm up patient's blood.These methods relate to from patient takes out blood, warms up and in equipment, warms up blood, and blood is sent and got back in patient body in outside.Although this class methods are all more much effective than previously described any straightforward procedure, they have shortcoming because of other reasons.First, related device is very heavy.Secondly, even also relate to some danger from a large amount of blood of the temporary transient taking-up of very weak patient.In fact, when initial taking-up blood tends to experience further temperature decline when warming up in external device (ED).Finally, use special conduit and directly warm up patient's blood.But the well-trained personnel of these conduits needs are inserted into device patient's central vessel, and these doctors only just have in specific unit, on ambulance, do not have, or even in emergency room, also seldom have.These instruments are also very expensive, are not therefore that each care-giver is available.
Nearest medical report has been described the means that use controlled hypothermia to be used as reducing oxygen consumption tissues such as cardiac muscle and brain during the perfusion that (correspondingly) occurs due to myocardial infarction and cerebral infarction is lowered, causes like this injury reduction and infarcted region to reduce.During medical report has also been described and prophylactically reduced art by controlled hypothermia during operation on heart or Interventional cardiac surgery or the postoperative injury from the ischemia in heart and brain and/or thromboembolism.
The ability preventing in treatment patient's myocardial infarction and apoplexy or greatly reduce the long-term injury to heart or cerebral tissue provides the urgent needs that causes wittingly the hypothermic method and system of therapeutic for the effective means with controlled.This type systematic is desirably portable and can be disposed at the scene by emergency medical service ambulanceman, and must be able to be quickly cooled to and close important heart and cerebral tissue with anti-damage as much as possible.But for noinvasive ground and cause fast that outside Intensive Care Therapy hospital environment hypothermic idealized system or method still do not exist.Cooling blanket provides the portable means that are easy to deployment that patient is lowered the temperature, but the self-thermoregulation mechanism of health is offset the cooling mechanism of this type of blanket by vasoconstriction.Therefore, cooling blanket can not cause in clinical correlation time the hypothermia in patient body in span.Ice bath due to cooling medium compared with large thermal gradient with compared with large specific heat capacity and can fast reducing patient temperature.But ice bath is not portable, such as the balloon angioplasty etc. required with treating MI (myocardial infarction) and apoplexy intervened inconsistent the necessary same period.The peritoneal catheter that is equipped with heat exchanger can quick cooling patient, but that the required size of this type of conduit becomes their deployment is traumatic.In addition, this type of catheterization needs those skilled in the art and must in hospital, carry out.Time arriving at hospital to patient, delay the time of many keys.Operate as heat exchanger by the lung with health self and use the gaseous fluid of frozen particles be suspended thing as convection current cooling medium can field deployment breathing cooling system can in span, cause hypothermia in clinical correlation time.But in such as the medical first aid such as apoplexy or MI, patient usually shows and breathes bad or suppress.In addition, breathe cooling mechanism also less than the cooling cooldown rate of peritoneum.
The apparatus and method for affecting patient temperature have been described in following patent and patent application.
These and the every other patent quoted herein and patent application are all by reference and entirety is incorporated into this.
background technology: describe for pogonip is delivered to patient at breathing gas and obtained hypothermic method and system with the common US 8,100123 transferring the possession of of the application and US2012/0167878.Whole disclosures of these patent documentations are incorporated to herein by reference.
WO03059425 adopts atomization fog to change a kind of method---body temperature reduction method of patient temperature, relates to and being applied in lower than the atomization fog at the temperature of patient temperature until patient's temperature 2 reduces.
US20030136402 adopts atomization fog to change a kind of method---body temperature reduction method of patient temperature, relates to and being applied in lower than the atomization fog at the temperature of patient temperature until patient's temperature reduces.
U.S. Patent No. 6,303,156 for raising or reducing the noninvasive method of patient's body temperature---and raise or reduce body temperature for example to treat hemorrhagic shock, comprising by hyperventilation and come administration of oxygen and sulfur hexafluoride gas mixture.
EP 1089743 is for raising or reducing the compositions that contains sulfur hexafluoride and oxygen of patient temperature---and raise or reduce body temperature for example to treat hemorrhagic shock, comprising by hyperventilation and come administration of oxygen and sulfur hexafluoride gas mixture.
WO9966938 is for raising or reducing the compositions that contains sulfur hexafluoride and oxygen of patient temperature---and raise or reduce body temperature for example to treat hemorrhagic shock, comprising by hyperventilation and come administration of oxygen and sulfur hexafluoride gas mixture.
US20030066304 brings out hypothermic method.Hypothermia for asystole patient is brought out Therapeutic Method, relate to asystole patient carry out phase transformation microgranule slurry continue use, until patient is induced to state of hypothermia.
U.S. Patent No. 6,547,811 bring out hypothermic method---improve asystole patient's prognosis by using phase transformation microgranule slurry in institute's precursor until bring out state of hypothermia.
WO0108593 brings out hypothermic method---improve asystole patient's prognosis by using phase transformation microgranule slurry in institute's precursor until bring out state of hypothermia.
US20030131844 uses helium-oxygen mixture to bring out hypothermia rewarming---be significantly different from admixture of gas normal human's temperature, that contain helium and oxygen for treating the useful compositions of ischemic event by bringing out hypothermia, comprise to have.
WO03047603 is for changing the breathable gas mixture of body temperature---be significantly different from admixture of gas normal human's temperature, that contain helium and oxygen for treating the useful compositions of ischemic event by bringing out hypothermia, comprise to have.
Summary of the invention
The invention provides for improving cooling optionally to bring out hypothermic method and system to patient.These method and systems rely on and produce air flow, and this air flow carries the freeze solid granule mist of carrying secretly or is suspended thing.Described air flow is through for the body surface of the part of patient breathing system or pass through from it, and at least some pogonip granules will melt, and makes the phase transformation causing thus absorb a large amount of body heats, thereby reduces body temperature.The enthalpy heat absorption being caused by the phase transformation of melting (or in some cases, distilling) from frozen particles provides than using through the possible larger heat absorption of cooling blast itself.To the body surface beyond the body surface in respiratory system in addition cooling favourable part be also, can easily contact many these type of surfaces, and patient needn't breathe in the time for the treatment of.
In a first aspect of the present invention, comprise the freeze solid granule mist generating in air flow for cooling patient's method.Described air flow is passed through on the target body table of a part that is not patient breathing system.Solid particle melts or distils to absorb body heat, thereby reduces patient's body temperature.Described body surface will be generally a part for body cavity, is usually located at patient's abdominal cavity or gastric.Or described body surface can be outer surface, such as the skin on patient's trunk.
In the time of cooling body cavity, conventionally make air flow pass stomach wall, and remove this air-flow (otherwise it will be accumulated in body cavity) by stomach wall.Conventionally, place inlet duct and outlet conduit through stomach wall, and introduce air flow and removed by outlet conduit by inlet duct.Conventionally, will use and introduce independent inlet duct and outlet conduit through the relative position on stomach wall, to promote circulation more completely in body cavity.In other cases, inlet duct and outlet conduit can be combined in single structure, this single structure is introduced by single the penetrating in stomach wall.
In the alternative, expose patient's skin or trunk.Skin or trunk will be covered by chuck or similar structure conventionally, and this structure covers at least a portion and the constrained flow moving air flow of trunk, makes its skin of cooling patient effectively.Chuck can be " bladder " form or other sealing systems, in this case, air flow will be in the outside of sealing recirculation, and will on chuck wall, transmit.In other cases, chuck can be opened to allow air flow directly to contact skin to conduct heat more efficiently.
Conventionally inject drop so that drop original position freezes to become frozen particles mist next life by cooled flow air-flow and in this stream.Can realize by conventional methods the cooling of gas, normally by the expansion via expansion valve to cause adiabatic cooling.Optionally, can also by microdroplet or form the liquid of microdroplet be injected into air flow in before it is cooling.Liquids and gases can comprise any suitable biocompatible fluid that significant enthalpy heat absorption is provided, and wherein frozen particles will be melted or distil under body temperature.Under common situations, liquid will be water, and gas will be air, nitrogen, helium-oxygen gas mixture (heliox), HF
6, carbon dioxide or another common gas.But,
In other cases, gas particles can be the carbon dioxide (dry ice) freezing, and it will distil to absorb heat in the time being exposed to body surface.Dry ice is optionally provided as solid block, and wherein this piece resolves into the granule that can be injected in air flow (therefore, air-flow is without cooling or be cooled equally).
In another aspect of this invention, comprise the generator of the frozen particles mist that produces air flow for cooling patient's system.This system also comprises that for air flow is guided to be not the mechanism of the body surface of a part for patient breathing system.Optionally, can build the not pogonip generator at frozen liquid in frozen gas flow.On the contrary, produce frozen particles mist at independent generator in such as nebulizer or ice fog machine.Ice fog machine can be refrigerated to the below freezing of water by the air solution with high humility conventionally.Little ice crystal nucleation with form little ice pellets frozen particles mist be suspended thing.Frozen particles mist can further mix with freezing flow of gaseous fluid, not freezing flow of gaseous fluid then mutually, or uses separately.
Generator can comprise for the cryoprobe of refrigerating gas, for generation of the pump of air flow with for liquid is injected to the nozzle through cooling air flow.Guiding device comprises tubular element, and this tubular element is used for penetrating stomach wall air flow is introduced to abdominal cavity or stomach.Alternatively, will adopt the first tube element and the second tube element to introduce air-flow and remove air-flow from this chamber.Alternatively, guiding device can comprise chuck, and this chuck is for being placed on patient with it with flowing on guiding patient trunk.
quote and be incorporated to
All publications and patent application mentioned in this description are all incorporated to herein by reference, as pointed out that particularly and individually each independent publication or patent application are incorporated to by reference.
Brief description of the drawings
Novel feature of the present invention is specifically set forth in the claim of enclosing.By reference to the detailed description and the accompanying drawings of being set forth using therein the Illustrative embodiment of the principle of the invention below, will obtain the features and advantages of the present invention are better understood; In the accompanying drawings:
Fig. 1 shows the system that produces pogonip by the fluid spray in cold airflow.
Fig. 2 shows the system of the stomach tube with two passages.A passage support flows into, and second channel support is flowed out.
Fig. 3 shows the peritoneum mist delivery system with at least two pins.
Fig. 4 shows the peritoneum mist delivery system with at least two conduits.
Fig. 5 shows the turbulent flow that can produce the air-cooled effect of expecting in peritoneum.
Fig. 6 illustrates and covers the suit of skin, and it has for delivery to the space of the pogonip of the skin under suit (have turbulent flow or without turbulent flow).
Detailed description of the invention
The operation of the present invention basis of describing is in the following embodiments the circulation of the freezing gaseous fluid in whole abdominal cavity, and what wherein frozen liquid had a frozen particles is suspended thing or mist.Conventionally, freezing gaseous fluid produces with frozen liquid source, and this frozen liquid source can comprise the container that stores the gas under compressive state and/or frozen state.The adiabatic expansion of gas produces the mobile stream of further freezing gas.Gas comprises air, helium-oxygen gas mixture (HELIOX, 20% O conventionally
2and 80%He
2mixture) or sulfur hexafluoride (HF
6), but can also comprise any biocompatibility gas with the specific heat capacity that is enough to be used in cooling down operation.Freezing gaseous fluid can alternatively be produced by suitable refrigeration system, such as driving refrigerator or any suitable gas refrigeration system known in the art to be produced by electric-driven refrigerating device, gas or propane.Frozen particles comprises ice conventionally, and by producing to the spraying of introducing second fluid (being generally aqueous water) through frozen gas stream from fluid source.The refrigerating gas being chilled to below the solidification point of water makes droplets freeze.Although granule comprises ice conventionally, also it should be understood that and can replace aqueous water with any biocompatible fluid with suitable freezing point, thermal capacitance and melting enthalpy.The cooling performance that is suspended thing (mist) and plays a role to strengthen gas/ice mixture of frozen particles.Overcome melting enthalpy and guaranteed that coolant temperature keeps close to 0 DEG C and to the maintenance of thermal gradient across organizing medium interface so that ice pellets melts required latent heat.Remove caloric requirement from patient's rapid moving and between the tissue being cooled and cooling medium, keep large thermograde.In addition, make frozen particles mist melt required phase transformation and increased the total amount of the energy that can remove from patient through the mixture of frozen liquid and mist.The general power removing from system is directly proportional by the adding rate of the ice pellets shown in calculating to table 1 as follows.
table 1
This calculating hypothesis ice under atmospheric pressure mixes with air; Air-ice mixture, at first in-30 DEG C, has the volume flow of 20l/min.
Figure 1 illustrates an exemplary embodiment of the present invention.Main pipeline 110 shown in figure in patient body, it penetrates patient's stomach wall AW to the mixture of frozen gas and pogonip is dispensed in abdominal cavity.The far-end 112 of main pipeline 110 is arranged in peritoneum P.Frozen liquid source 101 is connected to the main tube cavity 113 of main pipeline 110.Fluid port 114 allows to introduce the liquid from second body source 102.The nearside of fluid port 114 shown in figure in stomach wall, but it should be understood that fluid port 114 also can be positioned at the distally of stomach wall.Fluid injection port 114 can be suitable for making the liquid atomization, to make to form the mist of droplet in the time that fluid is introduced into frozen gas flow.Along with droplet and freezing flow of gaseous fluid 103 exchange heat energy, droplet freezes to form frozen particles and is suspended thing (mist) 104.Freezing gaseous fluid 103 leaves main pipeline 110 with the mixture 105 of frozen particles mist 104 and enters abdominal cavity with freezing tissue wherein.Can monitor following at least one with sensor bag 106: patient temperature, abdominal cavity body temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Pass through flow and temperature that data that used sensor bag 106 measures can be used for changing by processor/controller 107 generation of mixture 105 and flow rate, flow of gaseous fluid 103, to patient's temperature 2 is controlled within the scope of goal treatment.Should be appreciated that fluid stream 103 and mixture 105 can always not introduce in patient's abdominal cavity in a continuous manner.If processor/controller 107 receives and shows from the data of sensor bag 106 that the temperature of patient tissue is just being reduced under the therapeutic domain of appointment and reach potential harmful scope, processor/controller can change the characteristic of flow of gaseous fluid 103 or mixture 105 or stop or slowing down flow of gaseous fluid and/or the flowing of mixture 105.
Another embodiment of the present invention has been shown in Fig. 2.Main pipeline 210 shown in figure in patient body, it penetrates patient's stomach wall AW and is placed in patient's peritoneum P.Main pipeline 210 comprises inflow tube chamber 211 and flows out tube chamber 212.Flow into tube chamber 211 and be connected to freezing gaseous flow body source 201.Freezing flow of gaseous fluid 203 is flowed through and is flowed into tube chamber 211, and it meets with liquid (the being generally water) spraying of introducing at fluid injection port 214 places by fluid supply 202 herein.Liquid spray is frozen into the mist 204 of little frozen particles (being generally ice) by freezing flow of gaseous fluid.Freezing gaseous fluid 203 and the mixture 205 of mist 204 continue to enter into from flowing into tube chamber 211 among patient's abdominal cavity so that cooling patient.In the time that mixture 205 is heated and the frozen particles of mist 204 is melted, remove heat energy from patient.Further cooling in order to promote, can mixture 205 be extracted out from abdominal cavity by flowing out tube chamber 212, flow out tube chamber 212 and be optionally connected to vacuum source 208.Mixture 205 can be realized via vacuum source 208 or via the passive means that rely on the malleation producing abdominal cavity from the discharge in abdominal cavity.Mixture 205 guaranteed from the extraction in abdominal cavity that more mixture 205 can continue to flow through and flowed into tube chamber 211, and guarantees that mixture 205 keeps enough cold to guarantee cooling continuously and healthily to patient with respect to patient.Flow ipe 211 and outflow pipeline 212 correspondingly have independently valve 221 and valve 222 separately.This allows to occur independently or side by side the introducing of mixture 205 and the extraction of mixture 205.Flow into tube chamber 211 and can there is different length with outflow tube chamber 212, mixture 205 is introduced into abdominal cavity in the position different from the position that removes mixture 205 from abdominal cavity.Can do like this attempt to prevent shunting and in whole abdominal cavity, distribute better mixture 205.Can monitor following at least one with sensor bag 206: patient temperature, abdominal cavity body temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Processor/controller 207 is connected to freezing gaseous flow body source 201, fluid supply 202 and sensor bag 206 and vacuum source 208, and can control any the function in these elements.Pass through data that used sensor bag 206 measures and can be used for changing the amount of frozen particles mist in the generation of mixture 205 and flow rate, mixture 205 and mist 205 from the extraction speed in abdominal cavity and the driving of valve 221 and valve 222, to patient's temperature is controlled within the scope of goal treatment by processor/controller 207.Should be appreciated that processor/controller 207 can change the generating rate of the flow velocity of freezing gaseous fluid 202, mist 204 and the flow velocity of mixture 205 and the mixture 205 extraction speed from abdominal cavity independently.At any time, the flowing of freezing gaseous fluid 202, the generation of mist 204 and mixture 205 in abdominal cavity flow and mixture 205 all can be stopped by processor/controller 207 independently from the extraction in abdominal cavity.
Another embodiment of the invention has been shown in Fig. 3.Two pins shown in figure in patient body, flow into pin 311 and flow out pin 312.Shown in figure, flow into pin 311 and be inserted among patient's abdominal cavity with outflow pin 312, penetrate patient's stomach wall AW, their associated end is positioned at peritoneum P.Conventionally, flowing into pin 311 and flow out pin 312 is to be designed for the veress needle that arrives peritoneum and do not damage internal organs IO.But, also can use the known in the art any safty pin or the operation that are suitable for this purposes to enter pin.Flow into pin and be connected to freezing gaseous flow body source 301, this gaseous flow body source 301 produces frozen gas stream 303.The fluid injection port 314 flowing in pin 311 is connected to inflow pin 311 liquid flow body source 302 and produces liquid spray, and this liquid spray is frozen into the mist 304 of frozen particles, to produce the mixture 305 of freezing gaseous fluid and frozen particles mist.Mixture 305 then leaves inflow pin and enters among abdominal cavity, conventionally in peritoneum P.Thereby mixture 305 shown in figure flows and extracts heat 350 from described internal organs IO on internal organs IO, also should be appreciated that all tissue extraction heats the abdominal cavity from touching mixture 305.Removing the process of heat from patient's internal organs, mixture 305 will heating and mist 304 in frozen particles can melt.In order to ensure the heat extraction continuously and healthily from patient, by flowing out pin 312, mixture 305 is extracted out from abdominal cavity, flow out pin 312 and be optionally connected to vacuum source 308.Vacuum source 308 can be used for helping the extraction of mixture 305,
Alternatively can substitute and use the passive extraction that relies on positive dividing potential drop in abdominal cavity.Flow into pin 311 and be correspondingly equipped with separately independently valve 321 and valve 322 with outflow pin 312, to help to control flow velocity and the extraction speed of mixture 305.Can monitor following at least one with sensor bag 306: patient temperature, abdominal cavity body temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Processor/controller 307 is connected to freezing gaseous flow body source 301, fluid supply 302 and sensor bag 306 and vacuum source 308, and can control any the function in these elements.Pass through data that used sensor bag 306 measures and can be used for changing the amount of frozen particles mist in the generation of mixture 305 and flow rate, mixture 305 and mist 305 from the extraction speed in abdominal cavity and the driving of valve 321 and valve 322, to patient's temperature is controlled within the scope of goal treatment by processor/controller 307.Should be appreciated that processor/controller 307 can change the generating rate of the flow velocity of freezing gaseous fluid 302, mist 304 and the flow velocity of mixture 305 and the mixture 305 extraction speed from abdominal cavity independently.At any time, the flowing of freezing gaseous fluid 302, the generation of mist 304 and mixture 305 in abdominal cavity flow and mixture 305 all can be stopped or being restarted by processor/controller 307 independently from the extraction in abdominal cavity.
Another embodiment of the present invention has been shown in Fig. 4.Two conduits in the abdominal cavity of patient shown in figure, inflow catheter 411 and outflow conduit 412.Thereby inflow catheter 411 shown in figure and outflow conduit 412 penetrate stomach wall AW among being inserted into abdominal cavity, and their associated end is in peritoneum P.Inflow catheter and outflow conduit optionally insert on veress needle.Flow into pin and be connected to freezing gaseous flow body source 401, this gaseous flow body source 401 produces frozen gas stream 403.Fluid injection port 414 in inflow catheter 411 is connected to inflow catheter 411 liquid flow body source 402 and produces liquid spray, and this liquid spray is frozen into frozen particles mist 404 to produce the mixture 405 of freezing gaseous fluid and frozen particles mist.Mixture 405 then leaves inflow catheter and enters among abdominal cavity, conventionally in peritoneum P.Thereby mixture 405 shown in figure flows and extracts heat 450 from described internal organs IO on internal organs IO, also should be appreciated that all tissue extraction heats the abdominal cavity from touching mixture 405.Removing the process of heat from patient's internal organs, mixture 405 will heating and mist 404 in frozen particles can melt.In order to ensure the heat extraction continuously and healthily from patient, by flowing out conduit 412, mixture 405 is extracted out from abdominal cavity, flow out conduit 412 and be optionally connected to vacuum source 408.Vacuum source 408 can be used for helping the extraction of mixture 405, and alternatively alternative use relies on the passive extraction of positive dividing potential drop in abdominal cavity.Inflow catheter 411 and outflow conduit 412 are correspondingly equipped with independently valve 421 and valve 422 separately, to help to control the flow velocity of mixture 405 and extract speed out.Can monitor following at least one with sensor bag 406: patient temperature, abdominal cavity body temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Processor/controller 407 is connected to freezing gaseous flow body source 401, fluid supply 402 and sensor bag 406 and vacuum source 408, and can control any the function in these elements.Pass through data that used sensor bag 406 measures and can be used for changing the amount of frozen particles mist in the generation of mixture 405 and flow rate, mixture 405 and mist 405 from the extraction speed in abdominal cavity and the driving of valve 421 and valve 422, to patient's temperature is controlled within the scope of goal treatment by processor/controller 407.Should be appreciated that processor/controller 407 can change the generating rate of the flow velocity of freezing gaseous fluid 402, mist 404 and the flow velocity of mixture 405 and the mixture 305 extraction speed from abdominal cavity independently.At any time, the flowing of freezing gaseous fluid 402, the generation of mist 304 and mixture 405 in abdominal cavity flow and mixture 405 all can be stopped or being restarted by processor/controller 407 independently from the extraction in abdominal cavity.
Another embodiment of the invention has been shown in Fig. 5.Two conduits shown in figure, flow ipe 511 and outflow pipeline 512.Thereby flow ipe 411 shown in figure and flow out pipeline 412 and penetrate stomach wall AW among being inserted into patient's abdominal cavity, their associated end is in peritoneum P.Flow ipe 511 and flow out pipeline 512 can respectively do for oneself pin or conduit.Flow ipe is connected to freezing gaseous flow body source 501, and this gaseous flow body source 501 produces frozen gas stream 503.Fluid injection port 514 in flow ipe 511 is connected to inflow catheter 511 liquid flow body source 502 and produces liquid spray, and this liquid spray is frozen into frozen particles mist 504 to produce the mixture 505 of freezing gaseous fluid and frozen particles mist.Mixture 505 then leaves inflow catheter and enters among abdominal cavity, conventionally in peritoneum P.Thereby mixture 505 shown in figure flows and extracts heat 550 from described internal organs IO on internal organs IO, also should be appreciated that all tissue extraction heats the abdominal cavity from touching mixture 505.Removing the process of heat from patient's internal organs, mixture 505 will heating and mist 504 in frozen particles can melt.In order to ensure the heat extraction continuously and healthily from patient, by flowing out conduit 512, mixture 505 is extracted out from abdominal cavity, flow out conduit 512 and be optionally connected to vacuum source 508.Vacuum source 508 can be used for helping the extraction of mixture 505, and alternatively alternative use relies on the passive extraction of positive dividing potential drop in abdominal cavity.Flow ipe 511 and outflow pipeline 512 are correspondingly equipped with independently valve 521 and valve 522 separately, to help to control the flow velocity of mixture 505 and extract speed out.In this embodiment, in abdominal cavity, produce the turbulent flow 520 of mixture 505.Turbulent flow is by guaranteeing the fluid layer of the mixture 505 that contacts internal organs IO and good mixing of the remaining mixture 505 existing in abdominal cavity having improved the rate of heat transfer in peritoneum.This contributes between mixture 505 and internal organs IO, to maintain large thermal gradient, thereby guarantees the highest heat flow.Turbulent flow can generate by means well known in the art, such as the modified tip of pipeline 511 and pipeline 512, or by controlling pipeline 511 and the physical layout of pipeline 512 in abdominal cavity together with correspondingly controlling the flow velocity and the pressure that enter and leave the mixture 505 in abdominal cavity via pipeline 511 and pipeline 512.Can monitor following at least one with sensor bag 506: patient temperature, abdominal cavity body temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Processor/controller 507 is connected to freezing gaseous flow body source 501, fluid supply 502 and sensor bag 506 and vacuum source 508, and can control any the function in these elements.Pass through data that used sensor bag 506 measures and can be used for changing the amount of frozen particles mist in the generation of mixture 505 and flow rate, mixture 505 and mist 505 from the extraction speed in abdominal cavity and the driving of valve 521 and/or valve 522, to patient's temperature is controlled within the scope of goal treatment by processor/controller 507.Should be appreciated that processor/controller 507 can change the generating rate of the flow velocity of freezing gaseous fluid 502, mist 504 and the flow velocity of mixture 505 and the mixture 505 extraction speed from abdominal cavity independently.At any time, the flowing of freezing gaseous fluid 502, the generation of mist 504 and mixture 505 in abdominal cavity flow and mixture 505 all can be stopped or being restarted by processor/controller 507 independently from the extraction in abdominal cavity.
In alternate embodiment, show suit 630 depicted in figure 6.This suit have cervical region, abdominal part and both arms around tighten up district 631, to produce the sealing substantially of skin of the patient's trunk that reclines.Suit has at least one inflow port 611 that is connected to freezing gaseous flow body source 601 (multiple inflow ports shown in figure) and at least one and is connected to the outflow port 612 (multiple outflow port shown in figure) of vacuum source 608.Fluid body source 602 provides fluid liquid spraying, and this fluid liquid is sprayed in the stream from the freezing gaseous fluid 603 of freezing gaseous flow body source 601 and is frozen into frozen particles mist 604, to produce the mixture 605 of freezing gaseous fluid 603 and frozen particles mist 604.Mixture 605 is directed to the skin of patient's trunk by (one or more) inflow port.Mixture 605 conducts heat across patient's trunk, both arms and cervical region then, thereby removes heat to bring out state of hypothermia by skin from patient.Remove mixture 605 via (one or more) outflow port 612 that is connected to vacuum source 608.Can monitor following at least one with sensor bag 606: patient temperature, target organ temperature, the mobile speed of freezing gaseous fluid or fluid liquid are introduced speed.Passing through data that used sensor bag 606 measures can be used for changing the amount of frozen particles mist in the generation of mixture 605 and flow rate, mixture 605 and the mist 605 extraction speed from suit by processor/controller 607, to patient's temperature is controlled within the scope of goal treatment.At any time, mixture 605 in suit flow and mixture 605 all can be stopped or being restarted by processor/controller 607 independently from the extraction of suit.
In the embodiment shown in Fig. 1-Fig. 6, normally water of the liquid being provided by various fluid supplies, and mist described in these embodiments normally ice pellets be suspended thing.Should be appreciated that scope of the present invention is not limited to the use of liquid towards water.Can use any biocompatibility pogonip that is suitable for cooling purposes.For example, can produce dry ice pogonip by the dry ice particles of fine gtinding being incorporated in frozen gas flow, to produce the frozen liquid pogonip mixture described in above embodiment.
At the embodiment shown in Fig. 1-Fig. 5, can use routine operation to enter pin or conduit, such as safty pin (for example, veress needle), gastric pipe etc., pogonip that will the freeze solid granule that comprise air flow and wherein carry secretly is introduced in patient's abdominal cavity (being generally peritoneum or stomach) and/or is extracted out from patient's abdominal cavity.
Although illustrated and described the preferred embodiment of the present invention herein, it will be apparent to one skilled in the art that this type of embodiment only provides in the mode of example.Those skilled in the art now will expect not departing from numerous change of the present invention, change and replacement.Should be appreciated that the various replacement schemes that can adopt embodiment of the present invention as herein described in process of the present invention putting into practice.Following claim is intended to limit scope of the present invention, thereby and contains method and structure and the equivalents thereof in the scope of these claim.
Claims (21)
1. for cooling patient's a method, described method comprises:
Generation has the air flow of the freeze solid granule of carrying secretly; With
Make described air flow process on the body surface of a part that is not patient's respiratory system, wherein said solid particle melts to absorb body heat, thereby reduces patient's body temperature.
2. method as described in claim 1, wherein said body surface is arranged in body cavity.
3. method as described in claim 2, wherein said body cavity is abdominal cavity or stomach.
4. method as described in claim 3, is wherein incorporated into described air flow in described body cavity and by described air flow and is removed from described body cavity by described stomach wall by stomach wall through comprising.
5. method as described in claim 4, wherein introduces and removes and comprise through described stomach wall and place inlet duct and outlet conduit, and wherein said air flow is introduced by described inlet duct and flowed out by described outlet conduit.
6. method as described in claim 5, wherein said inlet duct separates with described outlet conduit, and introduces by the relative position on described stomach wall.
7. method as described in claim 5, wherein said inlet duct and outlet conduit are combined in single structure, and this single structure is introduced by single the penetrating in described stomach wall.
8. method as described in claim 1, wherein through comprising the skin that makes described air flow be exposed to patient.
9. method as described in claim 8, wherein said skin comprises the skin on described patient's trunk.
10. method as described in claim 9 wherein guides described air flow below covering at least a portion jacket structured of described trunk.
11. methods as described in claim 1, wherein generate mist and comprise cooling described air flow and inject drop in described air flow.
12. methods as described in claim 11, wherein cooling described gas comprises and makes described gas expansion to cause adiabatic cooling.
13. methods as described in claim 11, wherein generate described mist be also included in described microdroplet is injected to described air flow before or in cooling described microdroplet.
14. methods as described in claim 11, wherein said liquid comprises water, and described gas comprises air or nitrogen.
15. methods as described in claim 11, wherein said frozen particles is ice, and described air flow is air or nitrogen.
16. 1 kinds of systems for cooling patient, described system comprises:
Generation has the generator of the air flow that is wherein entrained with freeze solid granule; With
Be not the device of the body surface of a part for described patient's respiratory system for described air flow is guided to.
17. systems as described in claim 16, wherein said generator comprises: cryoprobe, for cooling described gas; Pump, for generation of described air flow; And nozzle, for to described through cooling air flow filling liquid to produce frozen particles at described air-flow.
18. systems as described in claim 11, wherein said guiding device comprises at least one tube element, and this tube element is used for penetrating stomach wall so that described air flow is incorporated into abdominal cavity or stomach.
19. systems as described in claim 17, comprise the first tubular element for introducing described air flow and for removing the second tubular element of described air flow.
20. systems as described in claim 16, wherein said guiding device comprises chuck, and this chuck flows with guiding on described patient's trunk with it for being placed on described patient.
21. systems as claimed in claim 18, wherein said guiding device comprises safty pin.
Applications Claiming Priority (3)
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|---|---|---|---|
| US201161531052P | 2011-09-05 | 2011-09-05 | |
| US61/531,052 | 2011-09-05 | ||
| PCT/US2012/053809 WO2013036540A1 (en) | 2011-09-05 | 2012-09-05 | Gastric, cutaneous, or peritoneal delivery of frozen mist to induce therapeutic hyperthermia |
Publications (2)
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|---|---|
| CN104010598A true CN104010598A (en) | 2014-08-27 |
| CN104010598B CN104010598B (en) | 2015-12-09 |
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Country Status (5)
| Country | Link |
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| US (3) | US9414959B2 (en) |
| EP (1) | EP2753273B1 (en) |
| JP (1) | JP6150802B2 (en) |
| CN (1) | CN104010598B (en) |
| WO (1) | WO2013036540A1 (en) |
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| JP2020501663A (en) * | 2016-12-13 | 2020-01-23 | クール セラピューティクス， インコーポレイテッド | Dense phase material transport in the pulmonary system |
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Also Published As
| Publication number | Publication date |
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| EP2753273B1 (en) | 2019-05-01 |
| US10238533B2 (en) | 2019-03-26 |
| WO2013036540A1 (en) | 2013-03-14 |
| EP2753273A4 (en) | 2015-05-13 |
| US20160324685A1 (en) | 2016-11-10 |
| CN104010598B (en) | 2015-12-09 |
| JP6150802B2 (en) | 2017-06-21 |
| EP2753273A1 (en) | 2014-07-16 |
| US20200038237A1 (en) | 2020-02-06 |
| JP2014525332A (en) | 2014-09-29 |
| US20130085554A1 (en) | 2013-04-04 |
| US9414959B2 (en) | 2016-08-16 |
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